Major institutional investors have increased their exposure to neurological disorder treatment companies in 2024 and 2025, with BlackRock, Vanguard Group, and Armistice Capital establishing significant positions across multiple therapeutic areas.
The sector has attracted a wide range of interest as companies advance treatments for conditions ranging from ADHD and Parkinson’s disease to hypertrophic cardiomyopathy and epilepsy.
While not everyone is bullish, the institutional positions generally reflect confidence in the commercial potential of specialized neurological therapeutics in the pipeline from several companies. These new drugs have the potential to benefit from defined patient populations, benefit from regulatory support for increased efforts to treat rare diseases, and relatively constrained competitive environments.
Recent quarterly filings reveal coordinated institutional activity across several neurological therapy companies with established commercial products and advancing clinical pipelines.
Support for Supernus Pharmaceuticals
Supernus Pharmaceuticals (NASDAQ: SUPN) has attracted institutional investment from major shareholders, including BlackRock, Vanguard Group, and Armistice Capital across its central nervous system portfolio. The neurological therapy specialist achieved full-year 2024 revenues of $661.8 million, reflecting a 9% increase compared with 2023.
There has been some trimming; Armistice Capital, for example, reduced its Supernus position by 260,000 shares during Q4 2024, representing a 5.1% decrease. However, the fund still retains a substantial position, and institutional interest remains strong across both passive index funds and active specialty investors targeting health care and pharmaceuticals.
Qelbree, Supernus’ non-stimulant ADHD treatment, generated 767,791 total prescriptions for calendar-year 2024, a 25% increase compared to the prior year. Fourth-quarter 2024 net sales of Qelbree increased 60% to $74.4 million, while full-year net sales reached $241.3 million, up 72% from 2023.
In the first quarter of 2025, Qelbree continued its strong trajectory with net sales reaching $64.7 million, a 44% year-over-year increase, driven by 214,908 prescriptions, up 22% from Q1 2024. March 2025 marked a new monthly high with 75,277 prescriptions. The prescriber base expanded to approximately 34,400 clinicians. Supernus reaffirmed its 2025 revenue guidance of $600–$630 million, supported by Qelbree’s momentum and targeted marketing efforts. In addition, the company received Paragraph IV certification notices related to generic viloxazine ER formulations and announced label updates to include pharmacodynamic data and information for breastfeeding patients.
The company achieved regulatory approval for ONAPGO (apomorphine hydrochloride) in February 2025, marking the first and only subcutaneous apomorphine infusion device for treating motor fluctuations in adults with advanced Parkinson’s disease. The approval provides Supernus with entry into the Parkinson’s disease market, complementing its existing neurological portfolio.
Cytokinetics Attracts Institutional Capital Ahead of FDA Decision
Cytokinetics has garnered institutional attention from funds including Armistice Capital, T. Rowe Price, and AQR Capital Management as the company awaits FDA approval for aficamten, its treatment for hypertrophic cardiomyopathy. Major institutional investors have maintained or increased their stakes despite regulatory uncertainties surrounding the drug’s approval timeline.
The FDA accepted Cytokinetics’ New Drug Application for aficamten in December 2024, initially setting a target action date of September 26, 2025. The agency later extended the review period to December 26, 2025, following a request for a Risk Evaluation and Mitigation Strategy, though no additional clinical data was required.
Aficamten has received Breakthrough Therapy Designation from both the FDA and China’s National Medical Products Administration for symptomatic obstructive hypertrophic cardiomyopathy. The pivotal Phase 3 SEQUOIA-HCM trial demonstrated the drug’s capacity to improve exercise capacity in patients with obstructive HCM, showing a 1.8 ml/kg/min increase in peak oxygen uptake compared to baseline.
Broader Neurological Investment Patterns
The institutional interest extends beyond pure biotech specialists to include broader healthcare-focused investors, suggesting confidence in commercial execution across multiple neurological conditions.
Vanguard and BlackRock maintain substantial positions through passive instruments, providing foundational institutional ownership typical of broad healthcare sector exposure. Specialty investors such as Armistice Capital make conviction-based decisions around clinical catalysts and commercial execution, while index funds provide baseline ownership regardless of company-specific developments.
Neurological disorder treatments often require chronic administration, creating recurring revenue streams that attract institutional capital. Demographic trends, including aging populations and improved diagnostic capabilities, expand addressable patient populations over time while regulatory incentives support orphan drug development for rare neurological conditions.
Market dynamics favor companies with novel mechanisms of action and differentiated clinical profiles, though development risks from clinical failures remain significant. Institutional investors evaluate these factors when determining position sizing in specialty pharmaceutical companies developing neurological therapeutics.
Future Outlook
Institutional participation across companies like Supernus Pharmaceuticals and Cytokinetics reflects measured exposure to neurological therapy development alongside other institutional participants in the sector. Recent clinical results, regulatory approvals, and commercial execution provide data points for ongoing investment evaluation across the institutional investor base.
The concentration of institutional capital in neurological disorder companies demonstrates general confidence in the sector’s ability to deliver both clinical value and commercial returns. Regulatory catalysts, established commercial products, and advancing clinical pipelines stand to continue to attract institutional attention in the coming quarters as companies execute on their neurological therapy development programs.
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